Dry Mouth

What is saliva?

Saliva, or spit, is made by your salivary glands. It helps keep you and your mouth healthy. For example:

• It moistens and breaks down the foods you eat, which makes it easier for you to chew and swallow.
• It washes away small food pieces from your teeth and gums, which helps fight against tooth decay.
• It contains minerals such as calcium and phosphate, which can also help fight tooth decay.
• It contains antibodies that can fight against infections of the mouth and throat. Antibodies are proteins that your immune system makes to fight foreign substances such as viruses and bacteria.

What is dry mouth?

Having dry mouth, also called xerostomia, means that you don't have enough saliva to keep your mouth wet. Everyone has a dry mouth once in a while, like when you are nervous or stressed. But if you have a dry mouth all or most of the time, it can be uncomfortable. It can make chewing, swallowing, and even talking difficult. It also raises your risk for tooth decay or infections in the mouth.

What causes dry mouth?

There are many possible causes of dry mouth, including:

• Side effects of certain medicines, such as some medicines for high blood pressure, depression, and bladder-control issues
• Diseases such as Sjogren's syndrome, HIV, salivary gland disorders, and diabetes
• Radiation therapy, which can damage your salivary glands if they are exposed to radiation during the treatment
• Chemotherapy, which can make your saliva thicker and cause your mouth to feel dry
• Nerve damage, when it involves the nerves that tell salivary glands to make saliva
• Breathing through your mouth
• Use of alcohol, tobacco, or other substances

What are the symptoms of dry mouth?

The symptoms of dry mouth may include:

• A sticky, dry feeling in your mouth
• Trouble chewing, swallowing, tasting, or speaking
• A burning feeling in your mouth
• A dry feeling in your throat
• Cracked lips
• A dry, rough tongue
• Mouth sores
• An infection in your mouth
• Bad breath

How is the cause of dry mouth diagnosed?

If you have dry mouth, it's important to find out the cause. To do that, your health care provider or dentist will review your medical history, examine your mouth, and ask about any medicines you take. They may also suggest blood tests or a test that measures how much saliva you produce.

What are the treatments for dry mouth?

Treatment for dry mouth depends on the cause. For example, if a medicine is causing dry mouth, your provider or dentist may suggest adjusting the dosage or switching medicines. In some cases, they might give you artificial saliva or a medicine to help your salivary glands work better.

There are also several things you can do to help relieve your symptoms:

• Drink plenty of water
• Avoid drinks with caffeine, which can dry out your mouth
• Chew sugarless gum or suck on sugarless hard candy to stimulate saliva flow
• Avoid spicy or salty foods because they can cause pain if your mouth is dry
• Avoid alcohol and tobacco
• Using a humidifier at night
• Use a mouthwash made for dry mouth

Since dry mouth can raise your risk of tooth decay, it's important to brush and floss your teeth regularly and see your dentist at least twice a year.

NIH: National Institute of Dental and Craniofacial Research

Eye Care

Why does eye care matter?

Eye care is about keeping your eyes healthy through good daily habits, regular checkups, and treatment when needed. Your eyes are an important part of your health. You rely on them every day to see and understand the world around you. Some eye diseases can lead to vision loss without early warning signs, so it's important to catch them as soon as possible. Get your eyes checked as often as your health care provider recommends, or if you notice new vision problems. Just like caring for the rest of your body, it's important to keep your eyes healthy.

How can I keep my eyes healthy?

There are many things you can do to protect your eyes and see your best:

• Give your eyes a rest. Spending long hours on a computer or other digital screens can make you blink less, causing dryness and tired eyes. To reduce eyestrain, try the 20-20-20 rule: Every 20 minutes, look away about 20 feet in front of you for 20 seconds.
• Wear sunglasses.Sun exposure can damage your eyes and raise your risk of cataracts and age-related macular degeneration. Protect your eyes by using sunglasses that block out 99 to 100% of both UV-A and UV-B radiation.
• Wear protective eyewear. To prevent eye injuries, you need eye protection when playing certain sports, working in jobs such as factory work and construction, and doing repairs or projects in your home.
• Avoid rubbing your eyes. Rubbing your eyes can transfer dirt and bacteria that may cause irritation or lead to an infection.
• Use good lighting. Brighten your space to reduce strain and help you see comfortably.
• If you wear contacts, take steps to prevent eye infections. Wash your hands before you put in or take out your contact lenses. Also follow the instructions on how to properly clean them and replace them when needed.

How can my nutrition and lifestyle habits affect my eye health?

What you eat and how you take care of your body can have a big impact on your eyes and vision:

• Eat a healthy, balanced diet. Your diet should include plenty of fruits and vegetables, especially dark leafy green vegetables like spinach, kale, or collard greens. Eating fish high in omega-3 fatty acids, such as salmon, tuna, and halibut can also help your eyes.
• Maintain a healthy weight. Being overweight or having obesity increases your risk of developing diabetes. Having diabetes puts you at higher risk of getting diabetic retinopathy or glaucoma.
• Get regular exercise. Exercise may help to prevent or control diabetes, high blood pressure, and high cholesterol. These diseases can lead to some eye or vision problems. Regular exercise helps lower your risk.
• Avoid smoking. Smoking increases the risk of developing age-related eye diseases such as macular degeneration and cataracts and can damage the optic nerve.
• Know your family medical history. Some eye diseases are inherited (passed down through families), so it is important to find out whether anyone in your family has had them. This can help you determine if you are at higher risk of developing an eye disease.
• Know your other risk factors. As you get older, you are at higher risk of developing age-related eye diseases and conditions. It is important to know your risk factors because you may be able to lower your risk by changing some behaviors.

What's the difference between an eye test and an eye exam?

Everyone needs their eyesight tested to check for vision and eye problems. Children usually have vision screening, also called an eye test, in school or at their provider's office during a checkup. This is a brief test that mainly checks how well you can see things up close and far away. Adults may also get vision screenings during their checkups. But many adults need more than a vision screening. They need a comprehensive dilated eye exam.

Getting comprehensive dilated eye exams is especially important because some eye diseases may not have warning signs. The exams are the only way to detect these diseases in their early stages, when they are easier to treat.

The eye exam includes several tests:

• Test your side (peripheral) vision with a visual field test. Losing peripheral vision may be a sign of glaucoma.
• Check how well you see at various distances with a visual acuity test, where you read an eye chart about 20 feet away.
• Follow an object with your eyes during an eye muscle function test to check for problems with the muscles that control your eyes.
• Shine a light into your eyes with a pupil response test to see how your pupils react to light.
• Measure the pressure inside your eyes with tonometry. This test helps to detect glaucoma.
• Dilate (widen) your pupils with special eye drops allows more light to enter the eye. Your eye care provider then uses a special magnifying lens to clearly see important tissues at the back of your eye, including the retina, macula, and optic nerve.

If you have a refractive error and are going to need glasses or contacts, then you will also have a refraction test. When you have this test, you look through a device that has lenses of different strengths to help your eye care professional figure out which lenses will give you the clearest vision.

When should I start getting eye exams?

How often you need eye exams depends on your age, race, risk factors, and overall health. For example, Black/African American adults are at higher risk for glaucoma and may need to start exams earlier. If you have diabetes, you should have an exam every year. Check with your provider about when you need these exams.

See an eye care specialist right away if you have symptoms like sudden loss of vision, double vision, blurred vision with eye pain, flashes of light, black spots or halos around lights. These symptoms may represent a serious medical or eye condition.

Foot Health

Each step you take involves a complex network of bones, muscles, tendons, and ligaments. This, combined with all of the weight they carry, explains why feet can have problems. To keep your feet healthy:

• Examine your feet regularly
• Wear comfortable shoes that fit
• Wash your feet daily with soap and lukewarm water
• Trim your toenails straight across and not too short

Your foot health can be a clue to your overall health. For example, joint stiffness could mean arthritis. Tingling or numbness could be a sign of diabetes. Swelling might indicate kidney disease, heart disease, or high blood pressure.

Good foot care and regular foot checks are an important part of your health care. If you have foot problems, be sure to talk to your doctor.

NIH: National Institute on Aging

Glaucoma

What is glaucoma?

Glaucoma is a group of diseases that can damage the optic nerve of one, or both, of your eyes. This can result in vision loss. There are different types of glaucoma, but the most common type is open-angle glaucoma. Other less common types include angle-closure glaucoma, and congenital glaucoma.

You may not have any symptoms of glaucoma. Regular eye exams by an eye care provider can check for glaucoma and other eye problems to help protect your vision. Treatments that lower eye pressure help slow the disease. Without treatment, glaucoma can eventually lead to blindness.

What causes glaucoma?

Medical experts aren't sure what causes glaucoma, but the most common types usually happen when the fluid pressure inside your eye slowly rises, damaging the optic nerve. Other types of glaucoma may be caused by medical conditions, or a baby may be born with it.

Not everyone with high eye pressure develops glaucoma. Some people may even get glaucoma with normal eye pressure. The amount of pressure your optic nerve can handle is different for each person. Getting regular dilated eye exams helps your provider figure out what level of eye pressure is normal for you.

What are the symptoms of glaucoma?

Often there are no symptoms of glaucoma at first. Or symptoms may start so slowly that you may not notice them. Without treatment, you slowly lose your peripheral (side) vision. It may seem like you're looking through a tunnel. Over time, your straight-ahead vision may decrease until no vision remains.

If you have sudden symptoms of intense eye pain, blurry vision, red eyes, or an upset stomach (nausea), you need to go to your eye care provider or an emergency room right away. These could be symptoms of angle-closure glaucoma. This less common type of glaucoma causes fluid to build up quickly in your eye.

How is glaucoma diagnosed?

A comprehensive eye exam can tell if you have glaucoma. This would include:

• A dilated eye exam. This involves getting eye drops that dilate (widen) your pupils. This allows more light to enter your eye. Your eye care provider examines your eyes using a special magnifying lens. This provides a clear view of important tissues at the back of your eye to check for glaucoma or other eye problems. For a few hours after the exam your vision may be blurry and sensitive to light, so you will need someone to take you home.
• Visual field testing. This check of your peripheral (side) vision allows your eye care provider to find out how well you can see objects off to the side of your vision without moving your eyes.
• Tonometry. This measures the pressure inside your eye.

If you're at higher risk for glaucoma, you should get comprehensive eye exams every one to two years. You're at higher risk if you:

• Are Black or African American and over age 40
• Are over age 60, especially if you're Hispanic or Latino
• Have a family history of glaucoma

You're also at higher risk if you have high blood pressure or diabetes and should get a dilated eye exam at least once a year. Talk with your provider about your risk and how often you should get your eyes checked.

What are the treatments for glaucoma?

Early treatment can help protect your eyes against vision loss. There is no cure, but glaucoma can usually be controlled. Without treatment it can eventually cause blindness. Treatments can include:

• Prescription eye drops are the most common treatment to lower the pressure in your eye and prevent damage to your optic nerve.
• Other treatments may include oral medicines, laser treatment, and/or surgery.

A combination of these treatments may be used to lower eye pressure and help drain the fluid out of your eye.

Can glaucoma be prevented?

There is no way to prevent glaucoma. Eye exams can help find glaucoma or other eye problems before they can affect your vision. If you have glaucoma, be sure to continue with treatment to prevent your vision from getting worse.

NIH: National Eye Institute

Gout

What is gout?

Gout is a common type of inflammatory arthritis. It causes pain, swelling, and redness in one or more joints. It usually happens as a flare, which can last for a week or two and then gets better. The flares often begin in your big toe or a lower limb.

What causes gout?

Gout happens when too much uric acid (urate) builds up in your body over a long time. Uric acid is a waste product your body makes when it breaks down purines. Purines are substances that are in your body's tissues and in many foods.

When your body breaks down old cells or digests foods that contain purine, most of the uric acid that's made dissolves in your blood. Your kidneys filter the uric acid out of your blood, and it leaves your body in your urine (pee).

However, sometimes your body can make too much uric acid or does not remove enough of it. Then the uric acid levels build up in your body, including in your blood. Having too much uric acid in the blood is called hyperuricemia. It does not cause health problems for everyone. But in some people, uric acid forms needle-like crystals. They can form in your joints, which causes gout. The crystals can also cause kidney stones.

Calcium pyrophosphate arthritis, sometimes called pseudogout, is a related disease. It causes similar symptoms and is sometimes confused with gout. But it is caused by a buildup of calcium phosphate, not uric acid.

Who is more likely to develop gout?

Many people develop gout. You are more likely to get it if you:

• Are male.
• Are older; it usually develops in middle age.
• Have obesity.
• Have certain health conditions, such as:
  • Heart failure
  • High blood pressure
  • Metabolic syndrome
  • Chronic kidney disease
  • Conditions that cause your cells to break down more quickly, such as psoriasis or some cancers
  • Rare genetic conditions that lead to increased uric acid
• Have a family history of gout.
• Have an unhealthy diet and eat foods that are rich in purines, such as red meat, organ meats, certain seafoods.
• Drink alcohol.
• Eat and drink lots of foods and beverages that contain fructose (a type of sugar).
• Take certain medicines, such as diuretics (water pills), low-dose aspirin, and some medicines that weaken your immune system.
• Take high amounts of niacin (vitamin B-3).

What are the symptoms of gout?

Gout usually happens in only one joint at a time. It is often found in the big toe, but can also affect other joints, including your other toes, ankle, and knee.

Gout flares often start suddenly at night, and the symptoms in the affected joint often include:

• Intense pain, which may be bad enough to wake you up
• Swelling
• Redness
• Warmth

The flares typically get better within a week or two. In between flares, you usually don't have symptoms. Some people may have flares often, while others may not have another flare for years. But over time, if left untreated, your flares may happen more often and last longer.

And if gout is untreated over long periods of time, you can develop tophi. Tophi are hard, uric acid deposits under the skin. They start out as painless, but over time, they can become painful. They can also cause bone and soft tissue damage and misshapen joints.

How is gout diagnosed?

To find out if you have gout, your health care provider:

• Will take your medical history, which includes asking about your symptoms.
• Will do a physical exam, including examining the affected joint(s).
• May order various tests, such as:
  • A test of a sample of fluid from one of your painful joints. The fluid is examined under a microscope and is checked for uric acid crystals.
  • A uric acid blood or urine test.
  • An ultrasound or special CT scan to look for uric acid crystal buildup in the affected joint and check for other conditions that may be causing the symptoms.

What are the treatments for gout?

There are effective treatments for gout. Which treatment you get will depend on your symptoms and the cause of your gout. The goals of your treatment will be to:

• Reduce the pain from gout flares, by using medicines such as:
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen.
  • Acetaminophen and the anti-inflammatory drug colchicine.
  • Oral or injected corticosteroids.
• Prevent future flares, for example by:
  • Making lifestyle changes such as losing weight, limiting alcohol, and avoiding foods high in purines. If you are taking medicines that can cause high uric acid in the blood, your provider may suggest stopping or changing those medicines.
  • If needed, taking medicines to lower uric acid in the blood.
• Prevent tophi and kidney stones, for example with medicines that lower uric acid in the blood.

With early diagnosis, treatment, and lifestyle changes, gout is one of the most controllable forms of arthritis. Treatment and lifestyle changes may help people avoid gout flares, lessen their symptoms, and sometimes even become gout free.

NIH: National Institute of Arthritis and Musculoskeletal and Skin Diseases